Casa Grande patients wait months for prescribed assistive devices

CASA GRANDE, AZ (3TV/CBS 5) — When doctors prescribe drugs, patients expect to get them in a timely manner, maybe the same day or the next. It’s supposed to be a similar process for medical devices. But for many who rely on that equipment, it’s taking much longer, especially for those that live outside the Valley metro. Advocates fear those device delays could get worse.

Many of the health insurance companies that operate under Medicare and Medicaid in Arizona have lost several of their in-network providers for medical devices. Some have closed, others find it’s not profitable with the reimbursements that have been set. It’s leading to months-long wait times.

“They’re extremely necessary,” Casa Grande resident Joe Moore said. He sent Arizona’s Family Investigates video of him getting in and out of bed. This everyday task that most of us take for granted is a challenge for the 75-year-old paraplegic, which is how he refers to himself. “How I get into bed should be with my Hoyer lift, and not a slide board because a slide board doesn’t always slide,” he said.

Joe said his doctor prescribed a fully automatic lift back in March, which would help him get in and out of bed himself. But, he said that’s not what Preferred Homecare, a medical device provider, delivered. “It causes a lot of pressure on me,” said Joe’s wife, Mary Moore, who is left struggling to help him.

Joe was hurt loading hay for his horses a decade ago at their home in Maricopa. They moved to Casa Grande soon after, hoping it would be easier for him to get around. “We’ve even had two doctors at once sending in prescriptions for the same thing and they still didn’t provide it,” Mary said.

Arizona’s Family Investigates asked Joe what the ordeal of receiving the wrong equipment has been like for him. “It’s been frustrating, especially when they decide they want to send the equipment they want to me to have out here and I’m on the phone telling them don’t send it,” Joe said. Arizona Healthcare Cost Containment System, the state’s Medicaid agency, said Preferred Homecare billed it $24 in November for that wrong lift. To make matters worse, Joe said, the company also delivered the wrong mattress. AHCCCS confirmed they denied that claim. Months later, the wrong mattress is gathering dust in Joe’s home.

Joe is still waiting on a chair, which would make it a lot easier for him to use the bathroom.

Coolidge Mayor Jon Thompson said residents have come to him with concerns. He said his stepson and in-laws also relied on similar devices and that the equipment meant “everything because neither one of them could get around.” He added, “it wasn’t nearly as bad as some of the problems we’ve had the last year or two.”

These medical devices are what’s referred to as durable medical equipment or DME. Doctors prescribe them, and they’re supposed to be delivered in a matter of days. That hasn’t been the case for Joe and at least five other Pinal County neighbors Arizona’s Family Investigates has heard from.

Industry insiders said the insurance companies operating under Medicare and AHCCCS have lost most of their DME providers. Preferred Homecare, which is owned by multinational corporation Linde plc, is one of the largest DME providers in the country, and one of the few left. Preferred Homecare declined our requests for an interview but, in a statement, wrote, “Due to adherence to protected health information (PHI), we do not comment. We appreciate your understanding.”

Bob Warda saw the need in this community. He opened Sonoran Medical Supplies with a business partner last year.

Arizona’s Family Investigates asked if he applied to be in-network with these health insurance companies. “Every one of them and they’re all closed to any new entrants. They say their data shows that the area is adequately served,” Warda said. “It’s created a monopoly, and they all have closed networks so that no one can enter.” He said his company was the only one in the state with the mattress Joe needed. Joe said he had to wait months until his insurance company authorized Sonoran Medical Supplies to deliver it in July. Warda said he’s still waiting to get paid and that he wants to help those that go to him. “I feel horrible that I have a piece of equipment that’s sitting right here and I can’t give it to them,” he explained.

Arizona’s Family Investigates reached out to the Centers for Medicare and Medicaid Services, the federal agency that works with states to carry out the insurance program. They write that patients “may be limited in their in-network provider choices” for DME “because the provider must be in-network for both the Medicare Advantage and Medicaid Plans.”

“It was a hard struggle,” Joe said. “Not just on my body but the frustration that I was dealing with the insurance companies for not delivering what I needed.”

Warda said he’s reached out to state and federal lawmakers, but to date, nothing has changed.

Arizona’s Family Investigates reached out to Senator Kyrsten Sinema’s office. A communications specialist said they know it’s a problem and encourage any families in need to contact her office. Here’s the email: Casework@sinema.senate.gov

Copyright 2022 KTVK/KPHO. All rights reserved.